License Verification

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TYESHIA JOHNSON

License Number: PA9112794

Data As Of 8/21/2025

Profession
Physician Assistant
License
PA9112794
License Status
Clear/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
11/14/2019
Address of Record
805 E CR 466
LADY LAKE, FL 32159
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
6868 Forest Hill Blvd
GREEN ACRES, FL 33413
Address
9955 Lake Worth Rd
LAKE WORTH, FL 33467
Address
4570 Lantana Rd
LAKE WORTH, FL 33463
Address
6699 Boynton Beach Blvd
BOYNTON BEACH, FL 33437
Address
1625 Federal Hwy
BOYNTON BEACH, FL 33435
Address
2272 N Congress Ave
BOYNTON BEACH, FL 33426
Address
3950 US 17/92 SUITE 1040
CASSELBERRY, FL 32707
Address
628 CAGAN VIEW RD SUITE 3 & 4
CLERMONT, FL 34714
Address
8972 TURKEY LAKE RD S
ORLANDO, FL 32819
Address
1984 ALAFAYA TRAIL SUITE 1000
OVIEDO, FL 32765
Address
5845 WINTER GARDEN VINELAND RD
WINDERMERE, FL 34786
Address
5833 SOUTH GOLDENROD RD SUITE 5 C & D
ORLANDO, FL 32822
Name Relationship Profession License Effective Date
WELLIVER, TODD ALAN M D Supervising Dispensing Practitioner Medical Doctor 92061 07/21/2025
WELLIVER, TODD ALAN M D Supervising Prescribing Practitioner Medical Doctor 92061 07/21/2025

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Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 8/21/2025



* To find out more about Approved Providers, or ask a provider why the course you took is not yet listed, please visit our Continuing Education Providers page.


** Personal Development is limited to no more than 3 hours per renewal cycle. Any personal development hours in excess of this 3 hour maximum cannot be used for renewal and have been subtracted from the total available for renewal.


Please do not fax proof of Continuing Education hours to the Board Office until you have received your renewal notice in the mail.


For instructions on how to request a license certification of your Florida license to be sent to another state from the Florida Department of Health, please visit the License Certifications web page.